Objective:

To evaluate the effects of commonly prescribed medications on fracture healing in adult patients.

Key Findings:

• Most evidence focused on fracture incidence or bone health rather than direct fracture healing outcomes.
• Nonsteroidal anti-inflammatory drugs showed limited effects on healing with short-term use but associations with delayed union or nonunion with prolonged exposure.
• Systemic corticosteroids reduced bone formation but lacked direct evidence on fracture healing outcomes.
• Vitamin K antagonists increased fracture risk, while direct oral anticoagulants showed lower fracture rates.
• Selective serotonin reuptake inhibitors were linked to increased fracture risk, but evidence on healing outcomes was limited.
• Metabolic diseases like diabetes were associated with delayed healing and higher complication rates.

Interpretation:

Medication effects on fracture healing are variable and depend on timing, duration, and patient characteristics, necessitating careful clinical consideration.

Limitations:

• Narrative design lacked quantitative pooling and formal risk-of-bias assessment.
• Heterogeneity in study design and outcome measures limited comparability.
• Evidence for many medication classes was indirect, focusing on fracture risk rather than healing-specific outcomes, and observational findings were subject to confounding by indication and comorbidity burden.

Conclusion:

The effects of medications on fracture healing are complex and should be interpreted in the context of individual patient factors and medication exposure.